Ronald W. Smith, M.D.

Fractures

fracture2I.      Definition:  When a bone breaks or cracks, it is called a fracture.  Pain, swelling, bruising, and discoloration are the most common signs of a fracture in the foot or ankle.  Common classifications of fractures include:
•    Acute fracture – a fresh break of the bone caused by a sudden blow or twist
•    Closed fracture – a broken or cracked bone that does not break through the skin
•    Comminuted fracture – a broken bone in which the bone is split into more than two parts
•    Displaced fracture – a break in the bone in which there is a significant separation of the ends of the bone
•    Open fracture – a broken or cracked bone that breaks through the skin.  The resulting open wound can greatly increase the risk of infection due to exposure of bacteria in the surrounding environment.
•    Stable fracture – a crack that extends through the bone, but does not shift the bone alignment
•    Stress fracture – a tiny crack in the bone surface due to repeated stress

II.      Cause:   Foot and ankle fractures are common among active individuals due to the physical demands placed on their feet and ankles.  Stress fractures occur with sudden increases in activity, repetitive stress on a particular area, improper training and stretching techniques, or firm training surfaces.  Stable and displaced fractures usually result from trauma, direct impact, or twisting of a bone.

III.      Treatment and Prevention:  Some ways to prevent stress fractures are:

•    Gradually increase new sports activity, incrementally working your way up to longer runs, or more extreme workouts.   Workouts should be spaced out between days of rest.
•    Maintain a healthy diet with calcium-rich foods.
•    Use proper athletic equipment.  Replace running shoes frequently.

Rest is the most important form of treatment once a stress fracture occurs.  Allow 6-12 weeks for the stress fracture to heal before resuming activity.
Stable and displaced fractures are prevented by avoiding injury or trauma.  Using proper athletic equipment, taking safety precautions, exercising regularly to build up muscle strength, and maintaining a healthy diet can decrease the risk of fracturing a bone.

If you think you may have fractured a bone, you should keep weight off the leg and apply ice to reduce swelling.   Aspirin or ibuprofen may help in reducing the pain.  See an orthopaedic specialist if after an injury:

•    Your foot pain includes swelling and causes a limp for longer than 2-3 weeks.
•    Your foot or ankle is black and blue after 1-2 days.
•    You cannot put weight on your foot after 1-2 days.

Most fractures can be treated without surgery.  If the fracture is in a toe, your orthopaedic specialist may “buddy-tape” the toe to an adjacent toe.  If the fracture is in another part of the foot or ankle, a cast or brace worn for 6-8 weeks may be necessary.  In extreme cases when the surrounding ligaments are torn or fragments of bone have broken away, surgery may be required.  Surgery can involve inserting screws, plates, or bands to hold the bones in place while they heal.    Rehabilitation and rest are important to ensure a full, speedy recovery.

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